MEDICARE: MEGAN O'SHEA FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	14616-33	WI

General Provider Information

NPI Number	:	1366223034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN O'SHEA FNP-C

Provider Business Mailing Address
First Line	:	1401 SUNDT LN
Second Line	:
City	:	STOUGHTON
State	:	WI
Zip	:	53589-1068
Country	:	US
Telephone Number	:	608-719-8032
Fax Number	:

Provider Business Practice Location Address
First Line	:	6000 MONONA DR STE 203
Second Line	:
City	:	MONONA
State	:	WI
Zip	:	53716-3329
Country	:	US
Telephone Number	:	608-419-7048
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/09/2023
Last Update Date	:	10/09/2023

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